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Organization
MY SMILE DENTAL
Active
Organization
MY SMILE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTINA MALLERY D.D.S. (OWNER/PROVIDER OF SERVICES)
(941) 748-9393
Entity
Organization
Contact information
Practice address
520 48TH STREET CT E, BRADENTON, FL 34208-5508
(941) 748-9393
(941) 748-9696
Mailing address
520 48TH STREET CT E, BRADENTON, FL 34208-5508
(941) 748-9393
(941) 748-9696
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN18531
FL
Other
Enumeration date
11/11/2009
Last updated
11/11/2009
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